title: Vascular effects of photodynamic and pulsed dye laser therapy protocols.
abstract: OBJECTIVE
  Pulsed dye laser (PDL) treatment of cutaneous vascular lesions is associated with variable and unpredictable efficacy. Thus, alternative treatment modalities are needed. Previous in vitro and in vivo studies have demonstrated enhanced selective vascular destruction with benzoporphyrin derivative (BPD) monoacid ring A photodynamic therapy (PDT) followed immediately by PDL irradiation (PDT+PDL). Here, we evaluate PDT alone, PDL alone, and PDT+PDL protocols using an optimized in vivo rodent dorsal window chamber model.
  
  
  METHODS
  A dorsal window chamber was surgically installed on male Golden Syrian hamsters. BPD solution was administered intravenously via a jugular venous catheter. Evaluated interventions included: (1) Control (no BPD, no light); (2) Control (BPD, no light); (3) PDT alone (lambda = 576 nm; 25, 50, 75, or 96 J/cm2 radiant exposure; 15 minutes post-BPD injection); (4) PDL alone at 7 J/cm2 (585 nm, 1.5 milliseconds pulse duration, 7 mm spot); and (5) PDT (25 or 75 J/cm2)+PDL (7 J/cm2). Laser speckle imaging was used to monitor blood flow dynamics before, immediately after, and 1, 3, and 5 days post-intervention.
  
  
  RESULTS
  Perfusion reduction on day 1 post-intervention was achieved with PDT>50 J/cm2, PDL alone, and PDT+PDL. However, by day 5 post-intervention, recovery of flow was observed with PDT alone at 50 J/cm2 (-15.1%) and PDL alone (+215%). PDT (75 J/cm2)+PDL resulted in the greatest prolonged reduction in vascular perfusion (-99.8%).
  
  
  CONCLUSIONS
  Our in vivo data suggest that the PDT+PDL therapeutic protocol can result in enhanced and persistent vascular shutdown compared to PDT or PDL alone. The PDT+PDL approach has potential for considerable superficial vascular destruction and should be considered as a treatment modality for cutaneous vascular lesions. Monitoring of blood flow changes for as long as possible is crucial for accurate assessment of light-based vascular interventions.
authors.affiliation: Beckman Laser Institute, University of California, Irvine, California 92612, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Channual
authors.forename: Bernard
authors.initials: B
authors.lastname: Choi
authors.forename: Kathryn
authors.initials: K
authors.lastname: Osann
authors.forename: Daniel
authors.initials: D
authors.lastname: Pattanachinda
authors.forename: Justin
authors.initials: J
authors.lastname: Lotfi
authors.forename: Kristen M
authors.initials: KM
authors.lastname: Kelly
mesh_terms: D000818:Animals; D006224:Cricetinae; D004195:Disease Models, Animal; D054025:Lasers, Dye / Q000627:therapeutic use*; D028022:Low-Level Light Therapy; D008297:Male; D008647:Mesocricetus; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000627:therapeutic use*; D011166:Porphyrins / Q000627:therapeutic use*; D017445:Skin Diseases, Vascular / Q000628:therapy*; D000077362:Verteporfin
chemical_list: D017319:Photosensitizing Agents; D011166:Porphyrins; D000077362:Verteporfin